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MedicaidReimbursementHigh impact

Annual Rate Changes Effective October 1, 2018

Illinois Medicaid - HFS·IL · Palliative Care·Provider Notice
Effective date
Oct 1, 2018
We identified it
Jun 20, 2026
Days to comply

Summary

Illinois Medicaid updated hospice reimbursement rates effective October 1, 2018, with new wage-adjusted rates based on Medicare hospice rates for federal fiscal year 2019. Hospice providers must use specific value codes (Value Code 61 for home care, Value Code G8 for inpatient care) with appropriate CBSA geographic identifiers on claims to ensure proper payment.

Action Required

Action needed
Immediately: Hospice billing teams must update claims to include Value Code 61 with appropriate CBSA for routine home care (Revenue Code 0651) and continuous home care (Revenue Code 0652) services. Use Value Code G8 with CBSA for inpatient respite care (Revenue Code 0655) and general inpatient care (Revenue Code 0656). Ensure only one value code per type is reported per claim to avoid rejections. Contact Illinois Medicaid hospice billing consultant at 877-782-5565 if billing a CBSA not in the state database.